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https://www.readbyqxmd.com/read/28631639/prevalence-of-clostridium-difficile-infection-among-the-patients-attending-a-tertiary-care-teaching-hospital
#1
Lavanya Segar, Joshy M Easow, Sreenivasan Srirangaraj, Mohammad Hanifah, Noyal M Joseph, K S Seetha
BACKGROUND: Clostridium difficile, a most important nosocomial enteric pathogen, is recognized globally as responsible for antibiotic-associated diarrhea and colitis. It is associated with considerable morbidity and mortality due to widespread use of antibiotics. AIMS: The study was done to determine the prevalence of C. difficile infection (CDI) among the patients attending a tertiary care teaching hospital in Puducherry. SETTINGS AND DESIGN: We performed a prospective cohort study in Mahatma Gandhi Medical College and Research Institute...
April 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/28624360/association-between-arterial-access-site-and-anticoagulation-strategy-on-major-bleeding-and-mortality-a-historical-cohort-analysis-in-the-veteran-population
#2
Jayant Bagai, Bert Little, Subhash Banerjee
BACKGROUND: Studies have shown reduction in major bleeding with trans-radial intervention (TRI) compared with trans-femoral intervention (TFI), and with use of bivalirudin compared with heparin+glycoprotein IIb/IIIa inhibitors (GPI). We compared major bleeding, mortality and the interaction between arterial access site and the anticoagulant used for PCI in Veterans. METHODS: A retrospective cohort of 1192 consecutive patients who underwent PCI at a VA hospital between 2006 and 2012 was divided into TFI-heparin (n=192), TFI-bivalirudin (n=272), TRI-heparin (n=274) and TRI-bivalirudin (n=454) groups...
June 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28623113/does-robotic-surgical-simulator-performance-correlate-with-surgical-skill
#3
James T Mills, Helen Y Hougen, Daniel Bitner, Tracey L Krupski, Noah S Schenkman
OBJECTIVE: To assess the relationship between robotic surgical simulation performance and the real-life surgical skill of attending surgeons. We hypothesized that simulation performance would not correlate with real-life robotic surgical skill in attending surgeons. DESIGN: In 2013, Birkmeyer et al. demonstrated an association between laparoscopic surgical performance as determined by expert review of video clips and surgical outcomes. Using that model of expert review, we studied the relationship between robotic simulator performance and real-life surgical skill...
June 13, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28622819/systematic-and-organizational-issues-implicated-in-post-hospitalization-suicides-of-medically-hospitalized-patients-a-study-of-root-cause-analysis-reports
#4
Natalie Riblet, Brian Shiner, Peter Mills, Brett Rusch, Robin Hemphill, Bradley V Watts
OBJECTIVE: Medical hospitalization is a high risk period for suicide. It is important to understand system-level factors that may be associated with suicide after a medical hospitalization. METHOD: Retrospective study of root-cause analysis (RCA) reports of suicide occurring within three months of Veterans Administration (VA) medical hospitalization, 2002-2015. We collected patient and system-level factors to characterize events. RESULTS: There were 96 RCA reports pertaining to suicide within three months of medical hospitalization...
May 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28618875/implementation-of-guideline-based-therapy-for-chronic-obstructive-pulmonary-disease-differences-between-men-and-women-veterans
#5
Seppo T Rinne, A Rani Elwy, Chuan-Fen Liu, Renda Soylemez Wiener, Lisa Thayer, Alexandra Gerity, Lori A Bastian
Chronic obstructive pulmonary disease (COPD) is common among both men and women, and guidelines recommend the same therapy for both sexes. While previous studies have identified gender differences in other chronic disease management, few studies have examined how implementation of COPD guidelines differs between men and women. We performed a cross-sectional study of veterans admitted to Veterans Affairs (VA) hospitals for COPD during October 1, 2008, to September 30, 2011. We collected information on baseline COPD medications during the 6 months prior to hospitalization and categorized therapies as "appropriate" or "inappropriate" based on current guidelines...
January 1, 2017: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/28605268/va-staff-perceptions-of-the-role-of-the-extended-care-referral-process-in-home-and-community-based-services-versus-nursing-home-use-post-hospital-discharge
#6
Edward Alan Miller, Orna Intrator, Emily Gadbois, Stefanie Gidmark, James L Rudolph
Little is known about how the extended care referral process-its structure and participants-influences Veterans' use of home and community-based services (HCBS) over nursing home care within the Veterans Health Administration (VHA). This study thus characterizes the extended care referral process within the VHA and its impact on HCBS versus nursing home use at hospital discharge. Data derive from 35 semi-structured interviews at 12 Veterans Affairs Medical Centers (VAMCs). Findings indicate that the referral process is characterized by a commitment by care teams to consider HCBS if possible, varied practice depending on the clinician that most heavily influences care team recommendations, and care team emphasis on respecting Veteran/family preferences even when they are contrary to care team recommendations...
June 12, 2017: Home Health Care Services Quarterly
https://www.readbyqxmd.com/read/28604324/cytomegalovirus-retinitis-in-cape-town-south-africa-clinical-management-and-outcomes
#7
Steven R J Lapere, James C Rice
BACKGROUND: Cytomegalovirus (CMV) retinitis is a vision-threatening opportunistic infection that occurs mainly in immunocompromised individuals. Limited data on treatment protocols and management outcomes are available in South Africa (SA). OBJECTIVES: To review the clinical presentation, management and outcomes of patients who were diagnosed and treated for CMV retinitis at Groote Schuur Hospital, Cape Town, SA, over a 10-year period, and to compare treatment protocols of 13 public hospitals in SA that treat patients for CMV retinitis...
May 24, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28601312/improving-staff-perception-of-a-safety-climate-with-crew-resource-management-training
#8
SreyRam Kuy, Ramon A L Romero
BACKGROUND: Communication failure is one of the top root causes in patient safety adverse events. Crew resource management (CRM) is a team building communication process intended to improve patient safety by improving team dynamics. First, to describe implementation of CRM in a Veterans Affair (VA) surgical service. Second, to assess whether staff CRM training is related to improvement in staff perception of a safety climate. MATERIAL AND METHODS: Mandatory CRM training was implemented for all surgical service staff at a VA Hospital at 0 and 12 mo...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28599817/user-centered-design-to-improve-clinical-decision-support-in-primary-care
#9
Julian Brunner, Emmeline Chuang, Caroline Goldzweig, Cindy L Cain, Catherine Sugar, Elizabeth M Yano
BACKGROUND: A growing literature has demonstrated the ability of user-centered design to make clinical decision support systems more effective and easier to use. However, studies of user-centered design have rarely examined more than a handful of sites at a time, and have frequently neglected the implementation climate and organizational resources that influence clinical decision support. The inclusion of such factors was identified by a systematic review as "the most important improvement that can be made in health IT evaluations...
August 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28593043/diffusion-of-clindamycin-resistant-and-erythromycin-resistant-methicillin-susceptible-staphylococcus-aureus-mssa-potential-st398-in-united-states-veterans-health-administration-hospitals-2003-2014
#10
Margaret Carrel, Michihiko Goto, Marin L Schweizer, Michael Z David, Daniel Livorsi, Eli N Perencevich
BACKGROUND: Changing phenotypic profiles of methicillin-susceptible Staphylococcus aureus (MSSA) isolates can indicate the emergence of novel sequence types (ST). The diffusion of MSSA ST can be tracked by combining established genotypic profiles with phenotypic surveillance data. ST398 emerged in New York City (NYC) and exhibits resistance to clindamycin and erythromycin but tetracycline susceptibility ("potential ST398"). Trends of potential ST398 were examined in a national cohort of all Veterans Health Administration patients with MSSA invasive infections during 2003-2014...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28587262/trends-in-pediatric-and-adolescent-anterior-cruciate-ligament-injuries-in-victoria-australia-2005-2015
#11
Louise Shaw, Caroline F Finch
Anterior cruciate ligament (ACL) injuries in children and adolescents have been the focus of recent media attention and parental concern, given their potential for adverse long-term health outcomes and healthcare costs. However, there is limited formal evidence on trends in the incidence of ACL injuries in children. This study utilizes the Victorian Admitted Episodes Dataset (VAED) to characterize epidemiologic trends of hospital-admitted ACL injuries in those aged 5 to 14 years over a period of 10 years from 2005 to 2015...
June 5, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28586576/non-arteritic-anterior-ischemic-optic-neuropathy-does-anticoagulation-help
#12
Akhunzada Muhammad Aftab, Mustafa Iqbal, Awais Rauf, Asif Ali
BACKGROUND: Non Arteritic Anterior Ischemic Optic Neuropathy (NAION) is the most common acute optic neuropathy in patients over 50 years of age. This study was conducted to determine the beneficial effects of anticoagulation with Heparin and Warfarin in patients with NAION presenting within 4 weeks of onset of symptoms. METHODS: A prospective, interventional, pilot study was conducted in Eye- A unit of Khyber Teaching Hospital from July 2010 onwards on patients with NAION presenting within 4 weeks of onset of symptoms...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28585065/the-right-vertebral-artery-originating-from-the-right-occipital-artery-and-the-absence-of-the-transverse-foramen-a-rare-anatomical-variation
#13
Zülal Öner, Serkan Öner, Ayşegül Sağır Kahraman
Variations in the origin of the vertebral artery (VA) is a congenital anomaly that occurs during embryological development. Multiple variations related to VA origin have been reported in the literature. Abnormal VA origin is usually determined as incidental findings during angiographic or postmortem anatomical studies. Although most of the cases are asymptomatic, in patients with VA anomaly symptoms such as dizziness have been described. The anomalous variation in the origin of the right VA is rare and separated into three categories: (1) originating from the aorta, (2) originating from the carotid arteries, (3) duplicated origin...
June 5, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28584677/microvascular-decompression-for-hypoglossal-nerve-palsy-secondary-to-vertebral-artery-compression-a-case-report-and-review-of-the-literature
#14
Yasuhiro Kuroi, Shigeru Tani, Hidenori Ohbuchi, Hidetoshi Kasuya
BACKGROUND: Neurovascular-compression syndrome (NCS) is described as a prominent pathological contact between cranial nerves and vessels. Trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia are typical clinical entities associated with NCS. On the other hand, the hyoglossal nerve is rarely affected by NCS. CASE DESCRIPTION: We present a case of hypoglossal nerve palsy (HNP) secondary to vertebral artery (VA) compression. A 47-year-old man presented to our hospital with a 1-month history of dysarthria and dysphagia...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28574495/black-patients-sustain-vision-loss-while-white-and-south-asian-patients-gain-vision-following-delamination-or-segmentation-surgery-for-tractional-complications-associated-with-proliferative-diabetic-retinopathy
#15
R Mastropasqua, Y H-L Luo, Y S Cheah, C Egan, J J Lewis, L da Cruz
PurposeThis retrospective comparative case series aims to determine whether patient ethnicity (White versus South Asian versus Black) is related to the outcome of surgical treatment for traction complications of severe proliferative diabetic retinopathy (PDR).SettingMoorfields Eye Hospital London, UK.MethodsAll patients who underwent vitrectomy with, delamination and/or segmentation for PDR over a 5-year period (2009-2014) were reviewed retrospectively. Patients were divided into White, South Asian or Black groups, and their age, gender, HbA1C and type of diabetes were recorded...
June 2, 2017: Eye
https://www.readbyqxmd.com/read/28574134/assessing-visual-function-behind-cataract-preoperative-predictive-value-of-the-heine-lambda-100-retinometer
#16
Michael Mimouni, Yinon Shapira, Janan Jadon, Shahar Frenkel, Eytan Z Blumenthal
PURPOSE: To analyze the accuracy of the Lambda 100 (Heine) potential visual acuity (VA) measurements in subjects undergoing cataract surgery. METHODS: The medical records of all consecutive patients who underwent clear corneal incision phacoemulsification cataract surgery by a single surgeon between 2010 and 2012 at the Department of Ophthalmology, Hadassah Medical Center, a tertiary care hospital in Jerusalem, Israel, were reviewed. Subjects age 18 or older with a follow-up time of at least 30 days were included...
May 26, 2017: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28570429/incidence-of-and-predictors-for-early-discontinuation-of-biological-therapies-in-veteran-patients-with-inflammatory-bowel-disease
#17
Linda A Feagins, Akbar Waljee, Jason K Hou, Phillip Gu, Steven Kanjo, Vivek Rudrapatna, Daisha J Cipher, Shail Govani, Jill Gaidos
BACKGROUND: Biological therapies are effective for inducing and maintaining remission in inflammatory bowel disease (IBD), but patients often require changes in biological agents over the course of their illness. We sought to evaluate the rate of and reasons for discontinuing biological agents and to identify risk factors for their discontinuation. METHODS: We performed a retrospective cohort study across 4 VA hospital systems (Dallas, TX; Houston, TX; Ann Arbor, MI; Richmond, VA)...
May 24, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28557861/heartmate-3-in-lowest-intermacs-profile-cohort-the-swiss-experience
#18
Piergiorgio Tozzi, Carlo Banfi, Kameran Ahmadov, Roger Hullin, Philippe Meyer, Raphael Giraud, Lucas Liaudet, Fabrizio Gronchi, Christophe Huber, Matthias Kirsch
New generation devices for long-term mechanical circulatory support are centrifugal pumps having fully magnetically levitated rotors to reduce blood trauma. Recently, the novel HeartMate 3 was cleared for clinical application in Switzerland. In two Swiss University Hospitals part of the "Lausanne-Geneva Transplantation Network," 10 consecutive patients in end-stage heart failure received the HeartMate 3. Device implantation criteria were persistent low output syndrome despite optimal medical treatment. The primary end-point of the study was survival or transplantation to 90 days on the device...
May 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28553783/a-retrospective-cohort-analysis-of-percutaneous-versus-side-graft-perfusion-techniques-for-veno-arterial-extracorporeal-membrane-oxygenation-in-patients-with-refractory-cardiogenic-shock
#19
Mehmet Cakici, Evren Ozcinar, Cagdas Baran, Ahmet Onat Bermede, Mehmet Cahit Sarıcaoglu, Mustafa Bahadır Inan, Mustafa Serkan Durdu, Atilla Aral, Mustafa Sirlak, Ahmet Ruchan Akar
OBJECTIVES: This study was designed to compare vascular complications and the outcomes of ultrasound (US)-guided percutaneous cannulation with distal perfusion catheter (PC-DP) and arterial side-graft perfusion (SGP) techniques in patients who require veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support for refractory cardiogenic shock (RCS). METHODS: We conducted a retrospective, observational cohort study of consequtive patients with RCS treated with VA-ECMO at a single transplant center from March 2010 until August 2015...
July 2017: Perfusion
https://www.readbyqxmd.com/read/28551923/-extracorporeal-membrane-oxygenation-in-israel-6-5-years-of-experience-at-the-largest-ecmo-treatment-center-in-israel
#20
Philip Biderman, Uri Carmi, Michael Fainblut, Oren Bachar, Benny Medallion, Dan Aravot
AIMS: The primary purpose of the study is to evaluate the characteristics of the population treated with ECMO at Beilinson Hospital, the treatment results and a comparison of results with ECMO centers in the world. The treatment outcomes relative to the experience of the team during the years 2008-2014 were also examined. The secondary purpose of this article is to increase the awareness of the medical staff to ECMO as a treatment option for patients with appropriate indications, where indications have increased in recent years...
April 2017: Harefuah
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